| NPI | 1538323175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD443573) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NJ 25MA09005100) |
| Enumeration Date | 2008-07-14 |
| Last Update Date | 2025-01-03 |